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Individual

MARK S RYBCZYNSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
9495 KEILMAN AVENUE, SUITE 3 AND 4, ST JOHN, IN 46373-9295
(219) 365-7000
(219) 365-2609
Mailing address
1040 SIERRA DR, STE 400, GREENWOOD, IN 46143-7240
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001056A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0090000854
BCBS GROUP NUMBER
IL
05
10021550
IN
Enumeration date
10/04/2006
Last updated
12/21/2011
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